BMJ Case Reports 2016; doi:10.1136/bcr-2016-216346

Pregnancy complicated by haemorrhagic ascites in a woman with newly diagnosed HIV

  1. Stafford Sansome1
  1. 1Homerton University Hospital NHS Foundation Trust, London, UK
  2. 2Department of Obstetrics and Gynaecology, University Teaching Hospital, Lusaka, Zambia
  1. Correspondence to Catrin Morgan, catrinannemorgan{at}
  • Accepted 11 July 2016
  • Published 29 July 2016


A young pregnant Zambian woman was referred from a district hospital in South Zambia to the university teaching hospital, Lusaka with severe anaemia and ascites. The ascites had developed over a month and the woman was currently 15 weeks pregnant. Further workup revealed that the patient was HIV-positive and the ascitic tap showed haemorrhagic fluid. After being reviewed by multiple doctors, the cause of the haemorrhagic ascites remained unclear; therefore, the decision was made to do a laparotomy. The laparotomy revealed haemoperitoneum and a large cyst attached to the liver containing 5 L of bloodstained fluid. The histopathology report revealed features consistent with a giant haemangioma. There were many barriers to accessing optimum healthcare in this case. These included limited access to blood, poor communication resulting in the patient being unaware of her HIV status and lack of patient education about HIV.

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